Associations between facility and regional characteristics with time to outbreaks of SARS-CoV-2 infection among residents*
| Characteristics | HR of outbreak of SARS-CoV-2 infection† (95% CI) | |
|---|---|---|
| HR | Adjusted HR | |
| Regional incidence of SARS-CoV-2 infection | ||
| Time-varying incidence in previous 14 d, increase in 1 case per 1000 | 2.03 (1.83–2.27) | 1.61 (1.42–1.83) |
| Facility characteristics | ||
| Total resident capacity | ||
| < 45 | Ref. | Ref. |
| 45–74 | 1.46 (0.86–2.49) | 1.53 (0.89–2.63) |
| 75–109 | 3.01 (1.87–4.85) | 2.36 (1.41–3.96) |
| 110–151 | 3.73 (2.35–5.93) | 3.24 (1.96–5.35) |
| ≥ 152 | 5.54 (3.52–8.73) | 3.56 (2.15–5.89) |
| Co-located with nursing home or LTC facility | 1.26 (0.90–1.75) | 1.66 (1.24–2.21) |
| No. of external care providers who enter facility daily | ||
| 0 | Ref. | Ref. |
| ≥ 1, exact number unknown | 2.14 (1.34–3.42) | 0.82 (0.52–1.29) |
| 1 or 2 | 1.22 (0.79–1.88) | 0.90 (0.58–1.38) |
| 3–6 | 1.96 (1.32–2.92) | 0.94 (0.63–1.43) |
| ≥ 7 | 3.26 (2.11–5.02) | 1.06 (0.68–1.64) |
| Missing | 1.25 (0.65–2.40) | 1.19 (0.31–4.50) |
| Staff-to-resident ratio | ||
| < 0.49 | Ref. | Ref. |
| 0.49–0.64 | 1.18 (0.82–1.68) | 1.21 (0.90–1.63) |
| 0.65–0.84 | 1.40 (0.99–1.99) | 0.96 (0.71–1.29) |
| > 0.84 | 2.04 (1.48–2.82) | 0.84 (0.62–1.14) |
| Missing | 0.95 (0.54–1.65) | 1.04 (0.32–3.41) |
| Size of chain | ||
| Not a chain | Ref. | Ref. |
| Small (2–5) | 0.94 (0.59–1.49) | 0.88 (0.55–1.40) |
| Medium (6–20) | 1.94 (1.41–2.66) | 1.40 (1.03–1.89) |
| Large (> 20) | 2.22 (1.67–2.95) | 1.34 (0.98–1.83) |
| No. of RH services available‡ | ||
| ≤ 6 | Ref. | Ref. |
| 7 | 1.95 (1.31–2.91) | 1.22 (0.82–1.83) |
| 8 | 2.29 (1.50–3.48) | 1.57 (1.05–2.36) |
| ≥ 9 | 4.65 (3.13–6.91) | 2.31 (1.55 – 3.43) |
| Community population size, n (%) | ||
| ≥ 500 000 | 4.75 (3.00–7.52) | 1.21 (0.72–2.04) |
| 10 000–499 999 | 1.80 (1.01–2.94) | 0.94 (0.58–1.52) |
| < 10 000 | Ref. | Ref. |
| Median household income in dollars | ||
| Quintiles 1, 2 (14 777–68 032) | Ref. | Ref. |
| Quintile 3 (68 352–84 160) | 1.01 (0.73–1.40) | 1.01 (0.77–1.32) |
| Quintiles 4, 5 (84 352–251 008) | 1.12 (0.87–1.44) | 0.83 (0.68–1.04) |
| Ethnic concentration,§ n (%) | ||
| Quintiles 1, 2 (less concentrated) | Ref. | Ref. |
| Quintile 3 | 2.20 (1.58–3.06) | 1.31 (0.91–1.88) |
| Quintiles 4, 5 (more concentrated) | 4.02 (3.08–5.24) | 1.63 (1.14–2.32) |
Note: CI = confidence interval, HR = hazard ratio, LTC = long-term care, Ref. = reference category, RH = retirement home.
↵* Mar. 1 to Dec. 18, 2020. Number of facilities: 770.
↵† As of Dec. 18, 2020. Defined as ≥ 1 case of SARS-CoV-2 infection among residents or staff.
↵‡ See Appendix 1 for the full list of services, available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.202756/tab-related-content.
↵§ Defined by the Ontario Marginalization Index as the proportion of residents who were not White or Indigenous and the proportion of immigrants who arrived in Canada within the past 5 years.